Key result
Isolated surgery for severe TR carries ~13% perioperative mortality, with atrial fibrillation predicting long-term risk.
Why the study?
Isolated tricuspid valve surgery is rarely performed and traditionally linked to poor prognosis, but its clinical outcomes remain little known.
What are the short- and long-term clinical outcomes of isolated tricuspid valve surgery in patients with severe tricuspid regurgitation?
Cohort (n=71)
No
What are the short- and long-term clinical outcomes of isolated tricuspid valve surgery in patients with severe tricuspid regurgitation?
Isolated tricuspid valve surgery for severe tricuspid regurgitation is associated with high perioperative and long-term mortality, although the majority of survivors achieve good functional status.
High mortality after isolated tricuspid surgery warrants cautious patient selection, especially with AF; leaves open optimal timing and indications in severe TR.
BACKGROUND: Isolated tricuspid valve surgery is a rarely performed procedure and traditionally is associated with a bad prognosis, although its clinical outcomes still are little known. The aim of this study was to assess the short- and long-term clinical outcomes obtained at our center after isolated tricuspid valve surgery as treatment for severe tricuspid regurgitation. METHODS: This retrospective study included 71 consecutive patients with severe tricuspid regurgitation who underwent isolated tricuspid valve surgery between December 1996 and December 2017. Perioperative and long-term mortality, tricuspid valve reoperation, and functional class were analyzed after follow up. RESULTS: Regarding surgery, 7% of patients received a De Vega annuloplasty, 14.1% an annuloplasty ring, 11.3% a mechanical prosthesis, and 67.6% a biological prosthesis. Perioperative mortality was 12.7% and no variable was shown to be predictive of this event. After a median follow up of 45.5 months, long-term mortality was 36.6%, and the multivariate analysis identified atrial fibrillation as the only predictor (Hazard Ratio 3.014, 95% confidence interval 1.06-8.566; P = 0.038). At the end of follow up, 63.6% of survivors had functional class I. CONCLUSIONS: Isolated tricuspid valve surgery was infrequent in our center. Perioperative mortality was high, as was long-term mortality. However, a high percentage of survivors were barely symptomatic after follow up.
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Sánchez-Espín et al. (2020) conducted a cohort in severe tricuspid regurgitation (n=71). Isolated tricuspid valve surgery was evaluated on Perioperative mortality. Isolated tricuspid valve surgery for severe tricuspid regurgitation had a 12.7% perioperative and 36.6% long-term mortality rate, with atrial fibrillation predicting long-term mortality (HR 3.014).
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